Abstract

Background: African American (AA) women are nearly twice as likely as non-Hispanic White (NHW) women to develop cardiovascular disease (CVD). The additional burden of CVD borne by AA women is attributed to socioeconomic status, psychosocial stress, and greater numbers of risk factors. Compelling evidence demonstrates that inflammatory biomarkers, such as heat shock protein-70 (hsp-70) are associated with CVD risk. Yet, little is known about how social determinants, such as perceived discrimination, subjective social status, and socioeconomic status, contribute to these inflammatory markers in women with CVD.

Purpose: The purpose of this pilot study was to examine the extent to which social determinants are associated with hsp-70 while controlling for age, race, and body mass index (BMI) in AA and NHW women with CVD.

Methods: The sample was comprised of 10 AA and 21 NHW (mean age=68.7) undergoing elective percutaneous coronary intervention or carotid endarterectomy. Participants completed the MacArthur Scale of Subjective Social Status ladders for both Community and United States. In addition, the, DASDS-Major Life Discrimination, and sociodemographic survey were completed. A blood sample was collected prior to intervention and was analyzed for hsp-70.

Results: Lower levels of subjective social status for community (r=-0.52, p=.02) and US (r= -0.43, p=.05) were associated with higher levels of hsp-70 controlling for age, race, and BMI. Further, greater reported frequency of major life discrimination (r=.520, p=.02) were related to elevated levels of hsp-70 adjusting for age, race, and BMI.

Conclusions: Results indicate that social determinants, in particular subjective social status and perceived discrimination, are associated with the inflammatory biomarker, hsp-70. Our findings support the importance of social mediators in the inflammatory cascade. Although longitudinal studies with larger samples sizes are required to confirm these results, findings imply that social determinants, which may be amenable to nursing intervention, play a more important role in predicting inflammatory markers of CVD than race.